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The main purpose of this study was to investigate the barriers to and facilitators of licensing, credentialing, and insurance reimbursement for substance use disorder (SUD) treatment providers across the nation. The study included an environmental scan of key issues, reviews of credentialing, licensing, and reimbursement policies in the 50 states and D.C., and in-depth case studies of four states that implemented innovative strategies to incentivize their SUD workforce. While SUD treatment is provided by professionals credentialed in a broad range of fields, including licensed professional counselors, clinical social workers, psychologists, psychiatrists, nurses, and physician assistants, this brief focuses on SUD-counselor credentials which vary the most from state to state.

This brief was prepared by the Human Services Research Institute under contract #HHSP233201600015 with the U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation, Office of Disability, Aging and Long-Term Care Policy. For additional information about this subject, visit the DALTCP home page at or contact ASPE Project Officers at HHS/ASPE/DALTCP, Room 424E, H.H. Humphrey Building, 200 Independence Avenue, S.W., Washington, D.C. 20201,,

DISCLAIMER: The opinions and views expressed in this report are those of the authors. They do not reflect the views of the Department of Health and Human Services, the contractor or any other funding organization. This report was completed and submitted on February 2019.